Responding to the Health Select Committee’s NHS Long-Term Plan: legislative proposals report, Helen Buckingham, Director of Strategy at the Nuffield Trust, said:
“Collaboration in the NHS is a good thing and the legislative proposals are right to aim for it, but there is a risk that collaboration could become cosiness – with inward-looking organisations doing what suits them, not what suits patients.
“The Select Committee rightly picks up that we need to know more about who will hold the NHS to account for doing the right things. When many NHS bodies locally are working as partners, how do we stop people marking their own homework and inappropriately funding their own services?
“Calls for greater transparency are sensible – but who will enforce this? We suggested local councils could provide oversight, and I was pleased to see that the Committee notes that option.
“Markets and competition in the NHS have not always delivered the anticipated benefits, but we do risk throwing the baby out with the bathwater. Patient choice could be undermined when, as the Committee says, it should be maintained and strengthened.
“The Committee rightly echoes our warnings about increased centralisation, and agrees that taking decisions on capital spending away from foundation trusts will undermine their ability to motivate staff to build up savings. The NHS in England is already quite a top-down system: it doesn’t need to become more so.”